Tuesday, March 29, 2005

The Morphine Connection

As an attorney with significant familiarity with medical issues, the fact that Terri Schiavo is receiving morphine doses (check article's end--credit to Drudge), makes me wonder whether Michael Schiavo's attorney, George Felos, really believes the dung he is shoveling, or he is simply a shill for the creepy right to die movement.

Morphine has only palliative value. It can only relieve pain and add comfort. But why on earth would a brain-dead person whose expedition towards the hereafter is described by Felos as "very peaceful. She looked calm..." require relief of pain? They claimed earlier that her alleged persistent vegetative state and alleged absence of cerebral activity precluded any experience of pain.

I am disregarding the comments of the Schindler family as to the status of Terri's strength and responses to stimuli, as people in crisis often see mirages in the depths of their despair. But what is one to make of Felos' claims that Terri is exhibiting "light moaning and facial grimacing and tensing of arms," which was the reason the morphine was administered? A response to the pain and suffering of starvation? Or yet another flippantly dismissed "involuntary reflex action"? But then why administer the morphine?

Whatever we make of this development, it cannot in the least be interpreted to be in any way consistent with any of the diagnostic statements made by the Schiavos. And so it seems that Terri's life and death have become a painful means to wicked, self-serving ends for these men. To Michael Schiavo it was a means to a financial end (the settlement cash) which he could not have touched had he simply divorced Terri. And to Felos, a right to death advocate, she may simply be one of the eggs you have to break to make an omelet.

ADDENDUM

Plenty of comments, but one of them reminds me of an ethical challenge dealt with by the Simpsons' Reverend Lovejoy, who proclaimed that anything is moral once the state sanctions it. Yes, we all know what the courts found. I'm a lawyer who tries cases and who sometimes sees judges find things that are completely outlandish. It doesn't make such findings correct. Because the Inquisition once found the earth to revolve around the sun...

16 Comments:

Blogger Terrie said...

Thank you for posting this, Peter. I reached the same sad conclusion myself.

3:36 PM  
Blogger S. Weasel said...

Well, that answers that. I've wondered. I assumed they were not giving her painkillers, for just the reason you discuss -- that it would be an admission there might be somebody still in there.

I have to be glad she's getting the benefit, but it certainly raises the question.

4:00 PM  
Blogger Eye Doc said...

"...hospice records show Schiavo was given two low doses of morphine - one on March 19 and another on March 26 - and that she was not on a morphine drip. The records show that the second dose was given after nurses noticed "light moaning and facial grimacing and tensing of arms," he said."


Sounds like she's at least intermittantly in pain to me. Nah, can't be. We all know how peaceful dying of starvation really is.

4:48 PM  
Anonymous Anonymous said...

I had a similar thought that I posted to the execrable Yahoo! discussion boards (where I go in frustration sometimes).

One question I have is whether or not this is grounds to make an evidentiary challenge to the Florida courts' contention that Terri is PVS?

From a practical standpoint, I strongly suspect Greer would turn this down as he has done so with all other challenges, including the ones based on an insufficient diagnosis of PVS (the absence of an MRI, PET, etc.). The man has essentially made up his mind regarding the evidentiary aspects of the case.

I should add that all too often in our court system, judges do so and refuse to revisit the issues. This happens frequently in death penalty cases as well (Though not universally thank heavens...there are some responsible judges out there). Appeals courts, since they rule on matters of law and the Constitution, can rarely address this in a satisfactory way, beyond habeus corpus claims, and we all saw what happened when such a claim, indeed a law, was proffered in this case.

One beigns to wonder what Greer would do if Terri, on her deathbed, were capable of actually clearly uttering the words "I want to live."

I still cannot believe that we are all sitting here, waiting and watching this woman die, given the evidence and medical record. The lesson here for many of us is that, if the courts decide you should die, you will die, regardless of what you want. The media has this backwards of course, as do the courts themselves. Terri is just the first of many victims to come.

6:13 PM  
Anonymous Anonymous said...

C'mon, you know the answer already. She's being given the morphine so she doesn't thrash around and upset people. Hospitals do this all the time. As for the experience of pain -- that's a complex thing, and clearly doesn't require consciousness or awareness per se. Even amoebas will draw back at unpleasant stimuli. There are certainly reflexes that occur in humans, e.g. if you touch a hot stove your hand jumps back before you are aware of the pain.

So Schiavo's position is that what she's going through may well be pain, in some lower animal sense, but isn't pain in the human sense. It's a consistent position. I don't think they're being duplicitous here.

The other position -- which I am more in sympathy with -- is that it is unethical to assume you can draw a bright line between "human" pain and "nonhuman" pain, or even to distinguish between the two forms of animal at all. This, too, is a consistent position.

7:47 PM  
Blogger ed said...

Hmmmm.

If you think that's crazy consider this:

I have yet to find an example of a living will where you *aren't* expected to opt for death.

There is literally no place to put "keep my fat ass alive and don't touch that damn switch!".

If that doesn't twist your knickers....

8:41 PM  
Blogger ed said...

This comment has been removed by a blog administrator.

8:45 PM  
Blogger ed said...

This comment has been removed by a blog administrator.

8:48 PM  
Blogger TM Lutas said...

At a certain point everybody (and that includes every culture of life advocate) says it's time to let go because what's being kept going isn't human. The only exceptions I can think are the cryogenics people and that's not quite what most people think of as "life support".

The US is actually very screwed up about when it's time to go. I'm a Catholic and I think that the Schiavo case is a 15 year crime committed under color of law. That being said, there is always a time past which you should go. I'm deeply disappointed with the US religious community that they've taught their flocks so poorly what that point is.

8:58 PM  
Anonymous Anonymous said...

"So Schiavo's position is that what she's going through may well be pain, in some lower animal sense, but isn't pain in the human sense."

Well, it's illegal to starve your dog to death in this country.

9:09 PM  
Blogger JAMES said...

Sadly, Terri is just brainstem and enough cortex to have some extremely minimal responses which superficially resemble cognition (repeating sounds, for example).

Her quality of life is about zero, and has been for years. Michael Schiavo is her legal power of attorney, and he has argued for withdrawal of support.

This happens every day. And most people want this option for themselves and their families.

Alive, brain-dead, PVS or somewhere on a spectrum - there is no reason for her to be denied opiates or basic nursing care: turning her, treating her skin, moistening her lips and oral mucosa. Just as would be done for a hopelessly ill sentient person who has elected to stop dialysis, or try to breathe without a ventilator.

9:27 PM  
Anonymous Anonymous said...

A rabid cat being put down in FL would get a fast lethal injection - THAT is "the law" in FL. Starving one would be a crime.

9:52 PM  
Blogger Ranee said...

James writes: Alive, brain-dead, PVS or somewhere on a spectrum - there is no reason for her to be denied opiates or basic nursing care: turning her, treating her skin, moistening her lips and oral mucosa. Just as would be done for a hopelessly ill sentient person who has elected to stop dialysis, or try to breathe without a ventilator.

What you say sounds good, but Michael Schiavo denied Terri those things while she was being "treated" at the hospice. She had bed sores, because the staff was told not to do things like turn her. That is neglect, plain and simple.

11:15 PM  
Anonymous Eric@bales.com said...

Ed,

You are right. There are few Advanced Medical Directives that encompass a Pro-Life ethic. I've been hammering out such a directive for over a year with an attorney. He couldn't provide much. His first stab wasn't worth... (you know).

I've researched quite a bit and drafted what I think is close to the mark. It's a shame I had to do most of the leg work. And to think, the original attorney is Catholic.

As a Catholic I made sure to include a caveat in its construction to involve the Catholic Church in such decisions and that my guardian (1st is spouse, 2nd respected friend) act in accordance with Church teaching.

12:59 AM  
Blogger JAMES said...

I think a lot has been said about Michael Schiavo - much of it without corroboration. For example, I heard that a former nurse signed an affidavit that Michael Schiavo tried to intimidate the nursing staff, etc. This account seemed to be embellished, going into detail about Terri's episodes of hypoglycemia always following Michael's visits, etc. (implying insulin poisoning attempts).

In many ways, Michael has been accused of neglect and attempted murder. That these serious allegations have never culminated in real charges reduces their credibility.

A lot is said in this debate, but we are watching from a distance, and not everything that is said is true.

It should also be noted that decubitus ulcers can occur even in properly cared for patients. If such an egregious order as "don't turn her" had really occurred, I think Terri's family would have had ample written, visual and video evidence of the results. Yet we haven't seen that.

I'm afraid we can't believe everything we hear or read. Michael may be an SOB, or not, but I think he still holds the legal cards and Terri's passing should be eased as much as possible.

Just to anticipate an objection, the fact that she has sensations does not mean she has cognition. Pain does not need to be endured here. It should be eased with opiates as necessary.

7:02 AM  
Blogger Bradley said...

Perhaps I'm missing something. I don't think Terri Schiavo should be kept alive. (As a matter of fact I think a they used far too little morphine.) It's not that I am opposed to her being alive but her wishes have been determined. The idea that this is an abortion case or civil rights case is ridiculous. This is about a woman who, it has been determined by numerous courts of law, would not want to live in this condition. Therefore, she has the right to refuse treatment and go willingly into death. The only way for her to die now is starvation. I hope she does die and, for her sake, I hope it's quickly.

11:19 AM  

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